Absence of Herpesvirus Dna by Polymerase Chain Reaction in Ocular Fluids Obtained From Immunocompetent Patients

Pendergast, Scott D.; Werner, Jane C.; Drevon, Ann M.; Wiedbrauk, Danny L.

doi:10.1097/00006982-200007000-00012

Cited by 34 publications

(13 citation statements)

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“…It is likely that with a larger test battery for foreign DNA, the yield of detection of specific infectious pathogens would be even greater. PCR from ocular fluids has a very high reliability with a very low false-positive rate [13–16]. False negative results are more difficult to verify as there is no gold standard for the accuracy of PCR and viral or Toxoplasma gondii cultures are rarely performed [17].…”

Section: Discussionmentioning

confidence: 99%

Aqueous humor polymerase chain reaction in uveitis – utility and safety

et al. 2016

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BackgroundTo study the value and safety of aqueous humor polymerase chain reaction (PCR) analysis for Herpes simplex, varicella zoster, cytomegalovirus, Epstein-Barr virus and Toxoplasma gondii in patients with uveitis.MethodsRecords of 45 consecutive patients with anterior and posterior uveitis who underwent AC paracentesis with PCR were reviewed. The main outcome measure was frequency of PCR positivity. Secondary outcomes were alteration of treatment, safety of paracentesis, and correlation of keratitic precipitates with PCR positivity,ResultsThe overall PCR positivity was 48.9 % (22/45). Therapy was changed because of the PCR results in 14/45 patients (37.7 %). One patient experienced a paracentesis related complication (1/45, 2.2 %) without long-term sequelae.ConclusionAqueous PCR altered the diagnosis and treatment in over a third of our patients and was relatively safe. Aqueous PCR should be considered for uveitis of atypical clinical appearance, recurrent severe uveitis of uncertain etiology, and therapy refractory cases.

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Section: Discussionmentioning

confidence: 99%

Aqueous humor polymerase chain reaction in uveitis – utility and safety

et al. 2016

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“…Two retinal diseases related to CMV infection were described in AIDS patients receiving HAART: classical retinitis and IRU that is related to a vigorous immune response to CMV ocular antigens [11, 12, 13]. IRU would occur in healed retina, due to an ocular inflammatory response to CMV antigens.…”

Section: Discussionmentioning

confidence: 99%

PCR with the Aqueous Humor, Blood Leukocytes and Vitreous of Patients Affected by Cytomegalovirus Retinitis and Immune Recovery Uveitis

Siqueira

Cunha²,

Oréfice

et al. 2003

Ophthalmologica

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Purpose: To detect the cytomegalovirus (CMV) genome by PCR in the aqueous humor, blood leukocytes and vitreous of patients affected by retinitis and immune recovery uveitis (IRU). Methods: A PCR for CMV genome detection was carried out with the aqueous humor, vitreous and blood leukocytes of 54 patients with retinitis, including 25 HIV-infected patients presenting CMV retinitis in different stages (active lesion 6 cases, healed lesion 14 cases and IRU 5 cases), and 29 non-HIV-infected patients (retinitis unrelated to CMV) as negative controls. Results: The CMV genome was detected in the vitreous, aqueous humor and blood leukocytes of 3 out of 6 HIV-infected patients, presenting active lesions in the retina. No CMV genome was detected in the vitreous, aqueous humor and blood leukocytes of the 5 HIV-infected patients presenting IRU. Conclusions: CMV genome detection by PCR in aqueous humor could be used as a specific and highly predictive technique for confirmation of this infection in the retina. The absence of CMV, based on the results of PCR done in clinical samples of the 5 IRU cases, does not confirm the hypothesis of a viral replication in the vitreous body and aqueous humor of these patients.

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“…Pendergast and associates reported that 75 aqueous and vitreous specimens from uninfected immunocompetent patients were negative for HSV 1 and HSV 2, VZV, CMV, and EBV by PCR. 8 The false-negative rate is more difficult to determine because often there is no other gold standard with which to compare, other than final clinical diagnosis, because viral cultures are among the least efficient diagnostic tests for intraocular fluid 9 and toxoplasmosis culture is performed rarely. 10 For this reason, validation in consecutive patients typical of those who usually undergo the testing is needed to assess the usefulness of the method for routine diagnostic use.…”

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confidence: 99%

Polymerase Chain Reaction Analysis of Aqueous and Vitreous Specimens in the Diagnosis of Posterior Segment Infectious Uveitis

Harper

Miller

Schiffman

et al. 2009

American Journal of Ophthalmology

165

118

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PURPOSE To assess polymerase chain reaction (PCR) analysis of intraocular fluid as a test for infectious uveitis of the posterior segment in a representative patient population. DESIGN Retrospective, interventional case series. METHODS One hundred and thirty-three patients with possible infectious chorioretinitis underwent PCR testing of aqueous or vitreous in a university setting. Baseline characteristics predictive of test positivity were identified. Positive and negative predictive values were calculated. RESULTS Four hundred and thirty-three PCR tests of 105 aqueous and 38 vitreous specimens (mean, 3.3 tests per patient) identified 77 of the 95 patients with a final clinical diagnosis of infectious uveitis (81%). Herpes simplex virus, varicella zoster virus, and cytomegalovirus PCR analysis were performed in almost all cases, with fewer tests for toxoplasmosis or Epstein-Barr virus. Clinical features associated with positive PCR results were retinal vascular inflammation (P < .001), optic nerve involvement (P = .008), immunocompromised state (P = .039), and extensive retinitis (P = .002). Cases sampled within one week of presentation were more likely to have positive PCR results than those sampled later (P = .071). The predictive value of positive and negative tests was 98.7% and 67.9%, respectively, in this patient group. Alteration in treatment based on PCR and syphilis serologic results led to resolution in 25 of 26 patients after treatment was changed. CONCLUSIONS PCR testing is a useful adjunct in the diagnosis of infectious causes of posterior uveitis. Cases with vascular or optic nerve inflammation, extensive retinitis, or immunocompromise are more likely to have positive PCR results and may benefit from PCR testing of aqueous humor.

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Absence of Herpesvirus Dna by Polymerase Chain Reaction in Ocular Fluids Obtained From Immunocompetent Patients

Cited by 34 publications

References 0 publications

Aqueous humor polymerase chain reaction in uveitis – utility and safety

Aqueous humor polymerase chain reaction in uveitis – utility and safety

PCR with the Aqueous Humor, Blood Leukocytes and Vitreous of Patients Affected by Cytomegalovirus Retinitis and Immune Recovery Uveitis

Polymerase Chain Reaction Analysis of Aqueous and Vitreous Specimens in the Diagnosis of Posterior Segment Infectious Uveitis

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